- All right, If you've got some, a clunky,
or a locking up knee that's popping,
we're gonna show you tests,
two tests, that you can do on your own.
You're gonna wanna see a doctor, possibly, if it's serious.
But anyways, at least you're gonna know what's going on
with the knee and it's gonna be that simple.
So, - Snap, crackle, pop.
- Yeah, and there you go.
Bob has spoken.
(both chuckle)
♪ Bob and Brad ♪
♪ the two most famous physical therapist ♪
♪ on the internet ♪
- Alright, before we get going, I want to clarify one thing.
And, Bob and I concur on this.
If your knee snap, crackles, and pops,
and there's no pain associated
with it. - Right.
You can go down like this, and up,
and it snaps, and crackles, and pops, zero pain.
It doesn't bother you throughout the day.
It's okay.
- Nothing to worry about.
- Right, that's just the way your knee is being.
- That's right.
If, however, if it's like that, and over time
it's gradually getting worse, or all of a sudden,
it does start to hurt, then you need to look at this.
- Or locks up.
- Yeah, or locks up. Good.
(air whooshes)
Now, if your knee happens to lock up,
and usually it's intermittently, sometimes with stairs,
and you just cannot move, and it is pain associated with it,
It's almost certainly a meniscus tear, or meniscus problem.
You agree, Bob?
- I agree.
- Okay, so one thing I do wanna talk about,
or I wanna show you what the meniscus is,
and this is a model of a knee.
This is the quadricep muscles here, the tibia bone.
So, it would looked like this.
The patella, or the kneecap, is actually getting in the way
to show you the meniscus.
So, with this model, we can flip it out of the way.
The meniscus is cartilage.
It supports and stabilizes the knee.
And it's, there's actually, it's kinda like a horseshoe
shape here, and all the way over to here.
This happens to be the ACL ligament.
But, this tissue here, the meniscus can actually tear,
it can fold over, a piece of it can break off.
All of those things can cause locking
and pain associated with it.
- As you get older, it can happen without trauma.
- Exactly, good point, Bob.
- You can have this happen just walking up the stairs,
or bending down in the flower garden.
Oftentimes, athletes get it from trauma.
- Get it from getting old.
- Yeah, exactly.
So, again, younger people get it.
What? I can't do anything here, Bob.
(both laugh)
What happened?
(air swooshes)
All right, so if you do have a suspected meniscus tear,
we're gonna show you two tests.
Typically, the the gold standard
if they really want to know for sure, they'll do an MRI.
And, these tests that we're gonna show you
are not conclusive.
- Right.
- If you test positive, doesn't mean 100% for sure.
You really need a professional that does a lot of them,
to know.
- Right.
- And, even then, they'll say, "let's confirm,"
- Right. - "With an MRI."
So, at least you know what's going on,
and you understand some of these tests.
So, the first one is, if it's my right knee
that's locking up, and I suspect of it,
the first test we're going to do, is the Thessaly Test.
Do on your good leg first.
So, simply, well, I'll do it, just say this is a good leg.
My knee is straight, I'm gonna bend it five degrees,
which you just can estimate, you know,
this is not five degrees, and a little bit isn't,
but it's not much.
A little flex in it.
Standing on that leg
and then, you rotate, back and forth.
- And then you twist and shout.
- Yep, twist and shout.
If it hurts and painful, that's a positive.
Then, the second part of this test, is go to 15 degrees,
which is just a little bit more.
If you're down here, that's too far.
So, five, 15, and rotate again.
if they are both painful, it's positive.
If they're both. - Meaning, you tore.
- Yeah, there's, like, suspicion you tore it.
- If you do it, and then there's no pain at all,
well then it's negative.
But, again, that doesn't mean for sure it's not.
- Absolutely not, right.
- Okay, the next one is called the Childress Test.
And, I call this the duck walk.
And, you'll see why in a little bit.
So, you stand shoulder width apart, you point your toes out
at about a 45, and you bend down.
This is the way I have it, doing with my patients.
I have their forearms go down,
till they touch their quadriceps, like this,
or hands like this.
And, simply see if you can walk like this.
You can go sideways, sideways, forward and backwards.
And, my experience is that if it's gonna hurt,
it hurts pretty quick.
- Right?
And, you just stop right away.
And, that's a positive test.
If both of them, if you do the duck walk, zero pain,
you do the Thessaly Test, zero pain.
Well, there's a.
- Again, positive meaning possible tear.
- Right, exactly right.
So, those are, there's other tests,
that if you go to see the doctor or a therapist,
these are not the only two.
- Yeah, they'll do, - There are others, as well.
- Yeah.
Okay, now let's go on to the next part
of if your knee clunks, that's a different story.
(air swooshes)
Okay, if your knees not locking up, but it feels unstable,
it's clunking, it just doesn't feel right,
it may be painful as well,
then it's a good chance that it may be a ruptured,
or torn, ASL.
And, to your cruciate ligament, which stabilizes the knee
in a front and backwards motion, which is really important.
Usually, these don't just tear without some kind of injury,
some trauma.
Oftentimes, it's like when you land, and you knee twists in.
- Yes.
- Like this, all at the same time.
- Football, soccer.
- Yeah, Basketball. - Right.
- Girls basketball in high school.
- Big time.
- Yeah, they have it more.
And it, there's a, there's a reason for it.
I don't want to get into it,
but my daughter played basketball,
and I seen a number of ACLs.
- Do you, really? - Over those four years.
- Wow.
- Playing, so.
Anyways, the test you can do that,
is simply lay down on a bed.
If you do this on a soft bed, this first test works okay,
the second one, not as much.
But, then you'd wanna do it on the floor.
So, lying on your back, bring both knees up.
Now, what we're going to do,
I'll demonstrate on this knee so you can see it.
But, you're gonna do this on the good knee first,
and get a feel for what.
- Do you wanna roll the pant leg up?
- Yep. We're gonna show Bob's leg.
Ooh, wow, you got a zipper and everything on here.
Look at that.
All right, there we go.
So, here we've got the tibia, okay?
And, here is the femur and the condyles.
Now, what do you do, is take your hands, go underneath here,
and I take my thumbs, and I go right over the joint line,
which is just below the kneecap.
You have to feel for a little hollow spot there.
This is where it takes a little skill.
And, then you simply pull out like this,
and you can actually do it without your thumbs there.
If you're looking right at this point, and you pull out,
this is stable.
Now, if you've got a torn ACL, and you do that
you likely may see this actually pull out,
and see a bump form here.
Bob, can I rip your ACL so we can get a good demonstration?
- Uh. - Just kidding.
So, if it just put your thumbs there, then you can feel it,
if it's not so obvious, visually.
So, do it on the good knee first, see how it feels.
Then do the sore knee.
By the way, if your knee is still swollen and sore,
you're not gonna do this test.
- No.
- And, a doctor won't either. - Too sore.
- They'll say, you know, "put some ice on it,
come back in a few days and test it again."
Oftentimes, it's confirmed by a MRI,
but these tests are pretty common.
There's a couple other tests.
I'm not gonna go through those that are more skilled.
Oh, I take it back!
This next one is my favorite test, actually.
I'm gonna, ah, we can leave that up.
Should we get right into it, Bob?
- Sure.
This is called the Lelli's Test.
It's a doctor, I believe he is in, from Europe.
I think he's a Italian doctor.
He is done a lot of ACLs, thousands of 'em.
- Right
- And, this is what he does for a test.
It's, they say it's one of the most accurate test,
manual tests, that you can do.
So, you can, like, on a bed like this, I can put a hard,
a firm bowl towel roll, or something under here that's firm.
And, that's gonna be a leverage point right there, okay?
Below the knee on the calf.
You're not gonna put it under the knee.
It will not work there.
It has to be completely away from the joint, okay?
Bob is going to relax.
You can see his heel is touching right there on the bed.
I'm going to push down right here.
Now, we're going to look at what happens with the heel.
When I push down, you can see the heel comes up immediately.
If the ACL is intact and healthy,
this is what's gonna happen.
Now, some people have lax ACLs, naturally,
so you're gonna do the good leg first.
- Right.
And then, compare how it responds to the sore knee.
If you push down, and there's a leg, in other words,
you push down and the heel doesn't come up,
or doesn't come up until you've pushed quite a ways,
that's an indication you got a torn ACL,
which typically means surgery.
Not always.
There are, you know, some people that.
- Right. - May not be,
very active or athletic.
- Probably won't heal.
- Yeah, yeah.
- It's not gonna probably heal on its own.
But, you can live without an ACL.
- Right. - But, that's something
you talk to your doctor about, so.
- Right. - Anyways,
I think that explains it, Bob, the ACL, the meniscus.
- Great. - All you need to know,
except for what you don't know.
(both chuckle)
Good luck with it,
and we hope your knees come out very healthy,
and you're back to your fun activities.
Bob, I'm gonna cover up your knee.
It's embarrassing.
(bob laughs)
(upbeat guitar strumming)